Occupational Therapy | Box 356490 1959 N.E. Neck muscles and bones are very small and respond well to treatment. This stops you from shrugging. Sit or stand with your arms in front of you and your palms facing forward. Spinal precautions. 0000006123 00000 n - Public transportation, Physical Rehabilitation OT: Conditions of the, Physical Rehabilitation OT: Tendon Injuries a, Physical Rehabilitation OT: Work Hardening an, Physical Rehabilitation OT: Total Hip Replace, Physical Rehabilitation OT: Bariatric Care, Physical Rehabilitation OT: Blood Pressure/Pu, Physical Rehabilitation OT: Burn Protocol, Julie S Snyder, Linda Lilley, Shelly Collins. Numbness, weakness and pain can happen throughout the arm and hand. endobj 0 The numbness causes you to be limited with holding items in your hands without dropping. .,\)yG'~t8m \]p~gkj |w&\mO9O ?'1w[(8.O?Ss_Lgf[(Ged27UKEJ/S're`od2KRj)-AvQQZRuf "-/'36*)I1cU+Yhp{q 3'$$,BrURHP]BTZ;Lx9*c iGA!u!9_jAG/EM" bNG&!^;5IM{I=T:6. -2f~tvL? For those patients who are followed in our clinic but who receive therapy from their local communities, our therapists are able to consult with distant health providers about continued care and treatment strategies to maximize progress. 0000005256 00000 n The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute Occupational therapy for people with spinal cord injuries. Thats how I usually describe it. Though the EMG test has been proven to not be very reliable as it can give false positives meaning it says you have a problem when the problem is not really there. - Elastic laces But opting out of some of these cookies may have an effect on your browsing experience. 0 Reference guide for all the Precautions for Occupational Therapy Treatment. Cervical spinal nerve roots branch off the spinal cord and go to specific locations in the arm. Monday to Friday, 8 a.m. to 6 p.m. (Eastern time), Monday to Friday, 9 a.m. to 5 p.m. (Eastern time). Kevin attended occupational therapy at the outpatient day treatment program for 6 months. Cervical spinal nerves send signals from the brain to the arms to move and enable sensation in the arm and hands. How long are these precautions in place for? NO trunk rotation NO traction on the spine Do NOT pull your child up in bed by the arms. Occupational and Physical Therapy are both offered at Hands-On Therapy by our experienced therapists who provide a comprehensive approach to your care. 235 0 obj <>/Encrypt 202 0 R/Filter/FlateDecode/ID[<273B5A8143F1A949823C638DA4F5BB00><2F8DB1E50BEDE44DADCBBB1478E17058>]/Index[201 68]/Info 200 0 R/Length 135/Prev 126605/Root 203 0 R/Size 269/Type/XRef/W[1 3 1]>>stream If exercises are the medication to help cervical radiculopathy getting the wrong dosage or the wrong medication can hurt more than help. For a great resource to provide your patients, you can print out thisActivities of Daily Living After Spinal Injury or Surgeryhandout from the University of Washington Medical Center. What would be the partial pressures of all species if NO\mathrm { NO }NO and Br2,\mathrm { Br } _ { 2 } ,Br2, both at an initial partial pressure of 0.30 atm, were allowed to come to equilibrium at this temperature? 3 Assistance Levels. Patients with upper . L, 1b`mP`Q G:L@kQBu@A6ui. Therefore, Understanding C6 Spinal Cord Injury: What to . Contact Information: [email protected] or 734-936-5017. Thanks so much for always having outstanding articles for our review! 68 0 obj <>/Filter/FlateDecode/ID[<433C4BBF0544361FFCF6118BCBA30B7E>]/Index[60 21]/Info 59 0 R/Length 59/Prev 291553/Root 61 0 R/Size 81/Type/XRef/W[1 2 1]>>stream endobj Hip Dislocation Precautions - Posterior Approach Making the switch from working in a non-orthopedic setting to an acute orthopedic setting can be a challenge for occupational therapists less familiar with patients following joint surgeries. ``OV45@#TX\4s ca:3EE@B,u@X,(` { to speak to our specialist after reading this blog if you are looking for answers on how therapy can help you specifically. Apply mild pressure to give yourself a deeper stretch (see Figure 2). startxref 1. 0000062968 00000 n Identify the element and draw orbital diagrams for elements with these atomic numbers: - Typically performed to decompress the spinal cord or to change the contour of the spine by cutting through the overlying muscle, connective tissue and ligaments to excise one or both lamina, facet joint, and/or spinous process, - May be indicated and must be used according to MD orders, - There may be orders limiting the amount of time a client is allowed to sit, - Difficulty with mobility and ambulation, - ADL retraining including dressing, bathing, G & H, toileting and mobility for self care with spine precautions. The general precautions immediately following shoulder arthroplasty are as follows, but may differ on an individual basis. - Long-handled sponge <]/Prev 967859>> Here at Hands-on Therapy Services, well talk to you first and get a history and find out what is your most important goal. 5.1 Respiration. All rights owned and reserved by Memorial Sloan Kettering Cancer Center, 2023 Memorial Sloan Kettering Cancer Center, Human Oncology & Pathogenesis Program (HOPP), Gerstner Sloan Kettering Graduate School of Biomedical Sciences, High school & undergraduate summer programs, Diaphragmatic (DY-uh-fra-MA-tik) breathing. Though the EMG test has been proven to not be very reliable as it can give false positives meaning it says you have a problem when the problem is not really there. 0000057607 00000 n Please do not write your name or any personal information on this feedback form. Nitric oxide and bromine at initial partial pressures of 98.4 torr and 41.3 torr, respectively, were allowed to react at 300. Repeat this in the other direction. <> 4/Jk| 4,v. These cookies do not store any personal information. Ask patient to bring his knee towards his <> Please invite your family member/caregiver to attend a physical therapy (PT) or occupational therapy (OT) session following your surgery. 7NP }D']ks$3xPip9jSEB*VVvY=4d6)NPXeH%8Bl#*gH7hH`xbl#t-7Z"- Dbx>X]yYVF&%|p#.V An anterior cervical discectomy is the most common surgical procedure to treat damaged cervical discs. Breathe out slowly through your mouth. For this reason, your doctor may prescribe occupational therapy to assist you in learning alternate methods to perform these tasks. 14 0 obj movements in varying positions) Restricted to 5 lbs with arm exercises (below 90 elevation) Abdominal Exercises (watch cervical spine), perform basic core strengthening of lumbar. startxref However, even amongst C6 spinal cord injury patients, functional outcomes will be different. 3. Spinal precautions include head holding, application of a cervical collar, patients . If you are committed to avoiding taking pills that dont work. 0000018164 00000 n 4 Function Goals & Emphasis. On the other hand, the individual may have no restrictions at all depending on the surgeon. xref Hold each stretch for 30 seconds, then relax. Cervical collar use- usually soft collar: 1 Level for 2 weeks, 2 Levels for 2-4 weeks, and 3 Levels <> You will read about the major joints since they are the most common orthopedic diagnoses you will see in the. U'eF|Om;>-ePMEi. - Bed transfers Oftentimes, EMG testing can help rule out compression at the elbow and wrist area. Occupational therapy to work on practical skills like dressing and cooking in cases that involve severe muscle weakness, . 2. <> Sit or stand with your arms at your sides. 00wtt00Utt40M@U-5X,!1Aa[GD60^aSd6b{K|K4,pJIA 5w0N``E5a&gU nif'@Aep+6e_Q` %7 This post was originally published on Feb 19, 2017 and updated on January 12, 2021 and February 8, 2023. Manual Therapy Grade 1 or Grade 2 joint mobilizations for neuromodulation of pain History of lower back issues even if you dont currently have pain. Pb/x$pg*>!Sir1{x `]o#p`vEf$WP'!.9YCz! The low back (lumbar spine) curves slightly inward. Do not lie on your involved side unless your healthcare provider says its OK. Do not lift or carry anything heavier than 3 pounds (1.4 kilograms) on your involved side. As you breathe out, slowly and gently pull your abdomen toward your spine. A second red flag that we want to be aware of is malignant tissue or the presence of metastases. Sit or stand and point your right arm downward. For more resources, visit www.mskcc.org/pe to search our virtual library. are invaluable to patients following spinal surgery or injury to adhere to spinal precautions and make dressing tasks achievable. E0&LfwAC)MDggggr2&c]N3lWz0 Published November 2021. Theres no commitment and no pressure. The best way to educate your patient in completing upper body dressing is to wear button-up, loose fitting shirts and to not use operative arm during the task. will also be invaluable for donning/doffing socks, shoes and threading pants. Cervical radiculopathy is often referred to as a "pinched nerve" in the neck, where the pain that may radiate down from the neck to the shoulder, shoulder blade, arm, or hand. Further education regarding ADLs can include these general precautions: I hope this gives you basic crash course in working with your first orthopedic patients! It is normal to feel frustrated, stressed, tired, or depressed after a major . Cardiac, Cervical, Chemo, Craniotomy, Fall, Mastectomy, Pacemaker, and more. Specifically note prior use of heat for this condition -Aggravating/easing factors (and length of time each item is performed before the symptoms come on or are eased) Cervical radiculopathy may cause nerve compression to due: That is, if you want to avoid taking pills, getting injections, and having surgery. X#Kd p%hPiP&Ih~OF;}X^-{'qElRrY&W#LX[IMnpYD1]$kIVQC_=l*Y v(=2 2h xM`=%_}U4WW2J(#vJ+SW7eIb9_})ld"RGVyv&^rIRlR9R0s6CL ;0!'0q{^eU\'3p|~9bu~yT_@476*5D+6VWf%l+XWl~x L*^lbVgT&c>N.M 3dJogY09 qNNo7/Tns'if.y|D/&'_:7y%%I\.Hd]%:(_ey6C2BYL7uQ)Y". If you are worried but scared to do anything because you are afraid of what therapy or surgery may do, consider talking to us first. Tuck your chin in and try to flatten the back of your neck against the wall (see Figure 5). Do the exercises slowly and smoothly. 0000004501 00000 n Actually, if you have cervical radiculopathy, it ALREADY means that you have left it to get worse over time and NOW you may be looking up what to do and how to treat it because the pain is getting worse, and you may be more worried about numbness getting worse. Treatment after a thoracic spinal cord injury may include: Learning basic activities of daily living: gaining independence with bathing, dressing, and toileting and learning to use . These can include weight-bearing precautions and/or anterior/posterior hip precautions. Gently turn your head so youre looking up and to the right. To doff the shirt, start with taking the shirt off the non-operative arm first, Use the non-surgical arm for all other basic ADLs until cleared (grooming, eating, bathing, dressing, cooking, etc. Hoang Tran is a Miami certified hand therapist , the owner of Hands-on Therapy Services and author of the book The Hands-On Approach. We will look at your shoulders and hands to see where there is tension and the nerves may be stuck causing you more aggravation. 0000006686 00000 n Do these exercises 2 times a day for 3 months. 0000003343 00000 n After a C6 spinal cord injury, individuals experience varying degrees of paralysis in the upper and lower body, also known as quadriplegia. Figure 3. If you cannot move your neck or shoulder after 3 months of doing these exercises, tell your healthcare provider. What happens if cervical radiculopathy is left untreated? Always check the doctors orders in case anything is different. This is a really great summary. In addition to the BLTs, instruct the patient to use the. Return to the starting position with your arms at your sides. Sheila Surmeier, OT demonstrates how to put on both a button-up and a pull over shirt with one hand. Cervical Radiculopathy . <> 247 33 The occupational therapist will Telehealth and online sessions are available! Whether your patient does or does not not have any specific precautions, ahip kit is recommended for lower body dressing due to the difficulty of bending forward to put on and take off shoes, socks, and pants. endstream endobj 378 0 obj <>/Metadata 51 0 R/OCProperties<>/OCGs[421 0 R]>>/PageLayout/OneColumn/Pages 375 0 R/StructTreeRoot 83 0 R/Type/Catalog>> endobj 379 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC/ImageI]/XObject<>>>/Rotate 0/StructParents 0/Type/Page>> endobj 380 0 obj <>/Subtype/Form/Type/XObject>>stream Starting too soon or too late can affect how well your shoulder and neck will work in the future. `F*^'KRhZ+ fvycR=S{H)$:QYP`gz2? 0000007204 00000 n This information will teach you how to do neck and shoulder exercises after your neck surgery. Ask client to "log roll" back into supine position. Activities of Daily Living Back/Spinal Precautions This handout gives general guidelines to follow after spinal injury or surgery. C8 This is great - now my thumb can manipulate. Be Patient with Yourself . hbbd```b`` A$:"jvK9X"+ILH +L ,`{a#T8b6M 0000017172 00000 n How can satellites stay in orbit without any jet propulsion system? Precautions: No lifting greater than 5 pounds until cleared by surgeon (usually by 4-6 weeks after procedure). This prevents you from pulling at your shoulder. For a single-level ACDF a soft collar is used for 2 weeks. Impinged nerves also will cause altered or absent sensation (feeling) in the arm along the route the nerve travels. 0000057568 00000 n 0 fk Many of these surgeries are seen only 1-2 times in acute care followed by outpatient OT or PT services depending on the surgeons referral. X30348 (05/2020) AAHC Cervical > Post Surgical Exercises - Spine. 0000001774 00000 n This site uses Akismet to reduce spam. Place the tip of your tongue behind your top teeth. 5. Each vertebra is separated by a gel-like disc that provides shock absorption for the spine. This category only includes cookies that ensures basic functionalities and security features of the website. 4l8,]f, Find out more about Online Marketing for Doctors. spine. Talk with your healthcare provider before lifting or carrying things over 3 pounds. Miscellaneous treatment considerations post laminectomy: - Instruction on spinal precautions is indicated and should be reinforced with all activity, 1. endobj <> This website uses cookies to improve your experience while you navigate through the website. 0000001158 00000 n Cervical Fusion Precautions: Anterior cervical fusion: avoid extension; Posterior cervical fusion: avoid flexion. Rely on effective 1-2 therapy with your implant. EMC Do not lift above shoulder level. V_YI93T":VMvh{ Pursuing basic and translational research across 9 programs and 100+ labs, Focusing on clinical cancer research and population health, Bridging the lab and the clinic through translational research, Fostering interdisciplinary collaborations between laboratory scientists and clinicians, Partnering with other academic and research institutions, Offering state-of-the-art resources for our researchers, Offering a curriculum with a focus on cancer, Connecting college seniors to future careers in biomedicine. Call your healthcare provider to tell them if this happens. %%EOF 377 0 obj <> endobj Even if you have tried therapy before, and got no relief, give us a call, , the owner of Hands-on Therapy Services and author of the book . There are three natural curves in the spine. Or want to avoid getting injections and surgery request a free discovery session. Cervical radiculopathy left untreated will get worse over time. CW,_Z~e.LZ[~n|~/ \ Q~Tp8@E%]`kF[6}cnli|dec0b~rJ* x|&P0b.4u?[zj YH'?y|8YEq{(;$,+D6s:0M_MmU h6h{Skh [mp1e+NU%u}_YH.Ss{ a~t>F (8lc For more in-depth home safety information, check out our article, Educating Patients on Home Safety Following Orthopedic Surgery. endstream endobj 165 0 obj <>>>/Filter/Standard/Length 128/O(R3UfV=T;in)/P -1340/R 4/StmF/StdCF/StrF/StdCF/U(sC?. They are usually given out after accidents or from urgent care centers. For example, some adaptive utensils can . There is little high-quality evidence on the best nonoperative therapy for cervical radiculopathy. Place your left hand on top of your head. - Bed mobility xZKo8i!/joR@#C(r;C;;H"of4//~F m.H]Jp0yINsC Just like anything else, not all therapy and therapists are created equal. Assess the needs of a person with a spinal cord injury. Explain using work-energy ideas. during bed mobility tasks to avoid twisting the spine. - Use of walker One of our clients has had issues with her neck and shoulders for 30 years. And along with the prior orthopedic surgeries, hip kits. 201 0 obj <> endobj NO side bending %%EOF It's an excellent resource that I definitely recommend to every new grad. 480 0 obj <> endobj Occupational and/or Physical therapy can improve neck motion, improve muscle imbalances, and get rid of the symptoms. In terms of therapy and the no going back serious is when the symptoms start to change and become more permanent. Providing assistance around the home during the first week after discharge. The hip kits generally include a reacher, long handled shoe horn, long handled sponge, dressing stick and sock aid to prevent the patient from breaking precautions and making the task possible. Neurostimulation is an effective, proven therapy for reducing chronic pain. - Raised toilet seat, - WC transfers Place your right hand on your left cheek and jaw. My OT Spot uses cookies to improve your experience. Cervical spinal stenosis is a narrowing of the spinal canal in the neck, mostly in adults 50 years and older, and can cause pain and other problems. [1][2][3] The segment of the spine most susceptible to injury is the cervical spine based on its anatomy and flexibility. Xm. Shoulder replacements/arthroplastiesare less commonly seen in the rehab setting since many of these patients go home shortly after the surgery. Qy=.tOB\JcMKh cervical postural strengthening -prone on elbows/quadruped - cervical retraction, add neck rotation and look forward -wall ball - (small playball) neck side bend -seated retraction with theraband 2 phase 2 - 4 to 8 weeks - strengthening objectives: improve scar tissue mobility and review body mechanics to minimize head forward position. hTP=k0+4t/!d4iwVrF636I^Zr{ae\a*+:Ln["-Z4\"opO;[dGSBtk?8#EP4`qd!vmoq kjld0fqls#g^b97C Eating with adaptive utensils and plate guards. This covers the traditional sternal precautions, with information about "Keeping your move in the tube" at end the of the article. It has every possible handout imaginable. A rule of thumb for the extremities is to keep them in their relaxed positions. If it was in the cervical spine, don't bend your neck. I get all of my handouts from The Occupational Therapy Toolkit by Cheryl A. %PDF-1.7 % 8\Oxw8URPPPfHB Do not lift or carry objects that weigh more than 5 to 8 pounds. Sometimes being very aggressive might feel good but then actually cause you pain later. 193 0 obj <>/Encrypt 165 0 R/Filter/FlateDecode/ID[<3E2241A432954A488A4FF122A7100986>]/Index[164 60]/Info 163 0 R/Length 115/Prev 98629/Root 166 0 R/Size 224/Type/XRef/W[1 2 1]>>stream This is particularly helpful for people that have had a . 2. Always check the doctors orders in case anything is different. Do not make any fast or jerky movements. The condition. =s6z(Gv o>o+uMe3? Full weight-bearing: 100% of body weight. `Z&5 xR^g%!OqCK8b*S,@. Do you even want to consider that and wait for it to get so bad? 16 0 obj 9. So, for this post, I wanted to make the transition easier for you by covering the biggest aspects occupational therapists encounter when working in orthopedics settings. Weight-Bearing Precautions. A physical therapist and an occupational therapist may exercise your arms, legs, and hands. 1. . No lifting, pushing, or pulling anything over 5-10 pounds. The cervical spine encompasses seven vertebrae and serves as a protection to the spinal cord. <> For the first 24 hours after your surgery: Wear a sling. textbook, or whichever phys dys textbook your school required. Or want to avoid getting injections and surgery . With cancer, where you get treated first matters. How much time? Just like anything else, not all therapy and therapists are created equal. 0000003229 00000 n OccupationalTherapy.com provides comprehensive courses offered for occupational therapy CEUs presented and authored by the leading experts, and delivered by the latest technology to meet the needs of the individual learner. Terms and Conditions. 0000010602 00000 n Working with a physical therapist can help you quickly . - Toilet transfers No low toilet seats, etc. December 4, 2019. Then we create a plan with you to help get rid of neck pain or the radiating numbness that is down in your fingers. Center brace evenly on the body before fastening straps. Watch your movements in a mirror to make sure you have good posture. It may be helpful to use a timer or clock to make sure you hold the stretches long enough. endstream endobj startxref <> Position client in supine and ask to "log roll" to their side, - The brace should be washed with a mild soap and water daily The goals of physical therapy for someone with spinal stenosis include: Improving range of motion of the lumbar spine. C6 Pick up sticks, tenodesis helps me exist. It is located in the abdominal and lower back region. If you have any questions, contact a member of your care team directly. xref One way that we are unique in our approach to treating cervical radiopathy, is how we address the above and below to actually get you relief. Symptoms that improve when lying down with the arm lifted over and behind the head. For your reference, a steam iron weighs around 3 pounds while a half gallon of milk is 4 pounds. Therapy may be recommended. endobj Wear your collar at all times or as recommended by your doctor. 0000016667 00000 n But the no pain no gain mentality does not work with this type of issue. "V9e,-dp-# 7$Q4MXU$TT:*zZdr 0000006200 00000 n 0000057682 00000 n The mid-back (thoracic spine) curves slightly outward. 0000011284 00000 n Follow these tips when doing your exercises. 0000002991 00000 n Relieving nerve compression. When ambulating, lead with the walker, then the surgical leg, followed by the non-surgical leg, being sure to keep the walker close, Keep the surgical leg elevated and extended with a towel roll under the heel when sitting or laying down, Avoid sitting in low chairs or surfaces. The goal is to foster independence . endobj Push your shoulders down and away from your ears. Strengthening the core muscles. There are several different phases that we address during your evaluation with us so that you can get lasting results. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Our scientists pursue every aspect of cancer researchfrom exploring the biology of genes and cells, to developing immune-based treatments, uncovering the causes of metastasis, and more. Decreasing pain and joint stiffness. 0000013168 00000 n Spinal Precautions After Cervical Surgery. While we read all feedback, we cannot answer any questions. Cervical Stenosis, Myelopathy, and Radiculopathy Cervical Spine Surgery Chronic Obstructive Pulmonary Disease Chronic/Persistent Pain Syndrome . Occupational Therapy Department Physiotherapy Department Acute Care Cervical Collar: Guidelines Patient and Carer Information Booklet If you have any further questions regarding the content of this booklet please contact your: Orthotist: Phone 02 9463 2303 Occupational Therapist: Phone 02 9462 9666 Physiotherapist: Phone 02 9462 9747 From diagnosis to treatment, our experts provide the care and support you need, when you need it. trailer 0000038403 00000 n After a full assessment, we develop a customized treatment program to meet each client's specific goals. For more in-depth home safety information, check out our article, No stepping backwards with surgical leg (lead with non-surgical leg when backing up to toilet, chair, etc. <> For a great resource to provide your patients, you can print out this. This helps ease pressure on the spinal cord or the nerve roots that may be caused by injury, herniated disk, narrowing of the canal (spinal stenosis), or tumors. How many milliliters of 0.125M0.125~M0.125M sodium carbonate solution would be needed to precipitate the calcium ion from 37.2mL37.2 \mathrm{~mL}37.2mL of 0.105MCaCl20.105~M\mathrm{~CaCl}_20.105MCaCl2 solution? i|t>b"fRx,>E#`BXP, 80 0 obj <>stream <> Your pain may worsen with certain neck movements. An individualized physical therapy treatment plan will be tailored to the patient's needs, addressing strength, flexibility and mobility impairments. Sep 2018 - Dec 20184 months. Limit neck motion as instructed by doctor. Prepare to wean from brace or cervical collar after 6 weeks, if neck brace has been used. Since then, she is able to sleep, get in and out of bed without pain and numbness, works the computer without suffering, her arms going numb, and countless other activities that she was missing out on because of fear. Spinal Precautions After Cervical Surgery. James Patient Education Handouts (A - Z) Click on the title to see the handout To narrow your search use "Ctrl + F" and enter a keyword . Short Term Goals (within 3 months): The mother will demonstrate the home exercise program for cervical spine ROM on the child with 100% accuracy during 2 consecutive therapy visits within 1 month. Anyone who sits for long periods, looks down at books or at computers, has jobs that use vibration types of tools, or over time loses motion in the neck region, also may be affected. Gently pull down your head toward your left shoulder, to stretch the muscles on the right side of your neck (see Figure 3). (Some patients LsL2/Ja%#L4kv. %%EOF Fear that she would become paraylzed at the slightest injury. endstream endobj 382 0 obj <>stream Gently pull down your head toward your left shoulder, to stretch the muscles on the right side of your neck (see Figure 3). Precautions . . While youre recovering, doing your daily activities may be harder for you. That patient may have metastases that . If you have been diagnosed with cervical radiculopathy or you have neck pain and you THINK this sounds like you request a free discovery visit to speak to our specialist after reading this blog if you are looking for answers on how therapy can help you specifically. I hope this answers some of your questions, concerns, or worries. Side neck stretch. Some surgeons will say 5 pounds, others will allow 10 . But first, let's discuss the reason why occupational therapy . . Also, I would recommend researching how to . Use common sense, follow your precautions, and do not be afraid to ask for advice from your doctor. Siz'oQk WL[apZwd. Ua+@19F6ylwdbDov]A;z;+=VP~@U W _x
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